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Review of leprosy research evidence (2002-2009) and implications for current policy and practice

VAN BRAKEL, Wim
et al
September 2010

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"The ILEP Technical Commission (ITC) advises ILEP member associations on technical aspects of leprosy. A major review of research evidence in leprosy was published prior to the International Leprosy Congress in 2002. This current report updates that review based on research published between 2002-2009 and focuses on interventions for prevention, early diagnosis, chemotherapy, reactions, prevention of disability, stigma measurement and reduction and rehabilitation in leprosy"
Leprosy Review, Vol 81, Issue 3

Hansen's disease recoverers as agents of change : a case study in Japan

HOSODA, Miwako
March 2010

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"This manuscript addresses the role and contribution of people affected by Hansen's disease (leprosy), especially through the efforts of Zen-Ryo-Kyo, the National Hansen's Disease Sanatoria Residents' Association, in changing laws and attitudes in Japan since the 1950's. Health social movements are discussed in the Japanese context and more broadly. An important contribution of this manuscript is the explanatory description of the activities of Zen-Ryo-Kyo in achieving change through addressing issues related to social stigma and discrimination"
Leprosy Review, Vol 81, Issue 1

A clinical and radiological follow-up study in leprosy patients with asymptomatic neuropathic feet

SLIM, FJ
et al
June 2008

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"An MRI study done in 2000 on 10 leprosy patients with neuropathic feet, without clinical complications such as ulcerations, osteomyelitis or Charcot deformities revealed abnormalities in nine patients, with degradation, interruption of subcutaneous fat and effusion/synovitis, all located in the first metatarsophalangeal (MTP) region. Since these MRI abnormalities may precede clinical complications of the foot, a follow-up study was performed. A new evaluation was based on a clinical examination and an MRI of the same patients who participated in the initial study...MRI findings of interruption and infiltration of the subcutaneous fat in leprosy patients with uncomplicated neuropathic feet do not necessarily have any clinical implication for the development of future foot problems"
Leprosy Review, Vol 79, Issue 2

Community based rehabilitation programmes : monitoring and evaluation in order to measure results

CORNIELJE, Huib
VELEMA, Johan P
FINKENFLUGEL, Harry
March 2008

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This paper aims to help develop "methodologies that will help to measure results of Community Based Rehabilitation programmes...The article places considerable importance on management information systems and monitoring, since it is believed that evaluation will greatly benefit from both the existence of baseline data as well as a well-developed and well-implemented information system. The present article emphasises the need for participatory processes in the development of baseline data and information systems. Four key areas for measuring CBR are highlighted: people, power, public society and partnerships. Finally, a tool is presented in order to evaluate (or monitoring and evaluation) systematically"
Leprosy Review, Vol 79, No 1

Evidence for the effectiveness of rehabilitation-in-the-community programmes

VELEMA, Johan P
EBENSO, Bassey
FUZIKAWA, Priscila L
March 2008

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"The present literature review identified 29 reports from 22 countries in Asia, Africa and Central America reporting on the outcomes of rehabilitation-in-the-community programmes in low and middle income countries published between 1987 and 2007. Interventions included home visits by trained community workers who taught disabled persons skills to carry out activities of daily living, encouraged disabled children to go to school, helped find employment or an income generating activity, often involving vocational training and/or micro-credit. Many programmes had a component of influencing community attitudes towards disabled persons. The information collected shows that such programmes were effective in that they increased independence, mobility and communication skills of disabled persons, helped parents of disabled children to cope better and increased the number of disabled children attending schools. Economic interventions effectively increased the income of disabled persons although they rarely made them financially independent. CBR activities result in social processes that change the way community members view persons with disabilities, increase their level of acceptance and social inclusion and mobilise resources to meet their needs"
Leprosy Review, Vol 79, Issue 1

Inclusion of persons affected by leprosy in CBR

CORNIELJE, Huib
et al
March 2008

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This article presents reflections of community-based rehabilitation (CBR) professionals who attended a workshop prior to the 17th International Leprosy Congress. The professionals discussed the need to make their rehabilitation programmes, often focussed on serving the needs of persons affected by leprosy, more inclusive for other marginalised groups, in particular persons disabled through non-leprosy causes. They also reflected on the need to promote the self-organisation of people affected by leprosy and their inclusion of them also in general Disabled People’s Organisations (DPOs) either individually or through their organisations
Leprosy Review, Vol 79, Issue 1

Funding for self-employment of people with disabilities : grants, loans, revolving funds or linkage with microfinance programmes

DE KLERK, Ton
March 2008

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"In 2005, Handicap International commissioned a study on the practices of funding for self-employment activities of people with disabilities (PWD), with a special focus on access to microfinance. The overall goal of the study was to produce a framework document highlighting good practices, strategies, tools and operational methods that guarantee the efficiency and sustainability of self-employment projects for PWDs. The first phase of the study consisted of a literature review and a worldwide survey. Through this first phase the research team identified the most innovative programmes for further analysis through field visits. In the second phase field visits were conducted in Afghanistan, Bangladesh, Ethiopia, India, Kenya, Nicaragua and Uganda, while regional workshops were organised in Dhaka and Nairobi. Phase three involved consolidation and analysis of the information and finally drafting of the framework document. This paper summarises the findings and good practices as presented in the framework document, based on the results of the literature review, the survey and the field research. It is not a scientific paper, i.e. it doesn't contain a discussion of the literature reviewed or systematic reference to sources, the same as the document on which it is based, as it is primarily meant for practitioners"
Leprosy Review, Vol 79, Issue 1

Global trends in disability rehabilitation and their implications for leprosy programmes

THOMAS, Maya
THOMAS, Maliakal Joseph
March 2008

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This article explores the global trends in disability rehabilitation and the implications for leprosy programmes. It provides a brief summary the Biwako Millennium Framework of the Asia and Pacific decade to gain a better understanding of current issues and the implications for leprosy rehabilitation programmes
Leprosy Review, Vol 79, Issue 1

Re-enablement of the neurologically impaired hand - 2 : surgical correction|Report of a surgical workshop held at Green Pastures Hospital and Rehabilitation Centre, November 2004, Pokhara, Nepal

SCHWARZ, RJ
BRANDSMA, JW
December 2006

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"In this paper, the common surgical procedures (of neuropathic conditions of the hand) are discussed. The procedures for uncomplicated neurologically impaired hand with paralysis of ulnar, median or radial nerve paralysis will be discussed first, followed by surgical interventions for the impairments that may have developed secondary to the paralysis or the surgery. Recommendations for best practice and further research will be given"
Leprosy Review, Vol 77, Issue 4

The relationship between detection delay and impairment in leprosy control : a comparison of patient cohorts from Bangladesh and Ethiopia

VAN VEEM, Natasja H J
MEIMA, Abraham
RICHARDUS, Jan H
December 2006

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"It is acknowledged that longer delays between first symptoms and diagnosis result in increased impairment in newly detected leprosy patients. However, it is unclear whether detection delay in relation to impairment can be used as a general or absolute performance indicator of leprosy control programmes. It is unknown whether similar delays always result in similar proportions of impairment. Therefore, the present study examined the quantitative relationship between delay and impairment in two different patient populations"
Leprosy Review, Vol 77, Issue 4

Risk factors for participation restriction in leprosy and development of a screening tool to identify individuals at risk

NICHOLLS, PG
et al
December 2005

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This paper explores risk factors for participation restrictions experienced by people affected by leprosy. The objective was to develop a screening tool to identify individuals at risk. An initial round of qualitative fieldwork in eight centres in Nepal, India and Brazil identified 35 potential risk factors for participation restriction. This was further assessed through quantitative fieldwork in six centres in India and Brazil. In all, 264 individuals receiving leprosy treatment or rehabilitation services made a retrospective assessment of their status at time of diagnosis. Their level of participation restriction was assessed using the Participation Scale, and regression analysis identified risk factors for participation restriction. Four consolidated items were identified as the basis for a simple screening tool to identify individuals at risk: physical impact of leprosy, an emotional response to the diagnosis, female gender and having little or no education. Such a tool may form the basis for a screening and referral procedure to identify newly diagnosed individuals at risk of participation restrictions and the need of actions that may prevent such restrictions
Leprosy Review, Vol 76, Issue 4

STEP : an intervention to address the issue of stigma related to leprosy in southern Nepal

CROSS, Hugh
CHOUDHARY, Ramesh
December 2005

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"This paper focuses primarily on the extent to which a Stigma Elimination Programme (STEP) affected the social participation of people affected by leprosy in southern Nepal. The Participation Scale (popularly known as The P Scale) was applied to compare leprosy affected people who participated in STEP groups with a control group comprising leprosy affected people who lived in villages where STEP had not been implemented"
Leprosy Review, Vol 76, Issue 4

WHO disability grading : operational definitions

BRANDSMA, J Wim
VAN BRAKELl, Wim H
2003

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"The paper discusses the WHO grading in the light of its dual use: as an indicator for early case detection and as an indicator for change in impairments. The paper presents operational definitions for the grading options"
Leprosy Review, Vol 74, Issue 4

The experience of self-care groups with people : ALERT, Ethiopia

BENBOW, Catherine
TAMIRU, Teferra
September 2001

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This paper describes the development of self-care groups in Ethiopia by ALERT, and the successes and failures experienced in the process. The groups were started in 1995 in response to two main problems, the increasing number of people dependent on ALERT to heal their wounds despite years of health education, and the limited financial resources of ALERT for wound healing supplies
Leprosy Review, Vol 72, Issue 3

An intensive self care training programme reduces admissions for the treatment of plantar ulcers

CROSS, Hugh
NEWCOMBE, Lesley
September 2001

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"This paper describes, in detail, an intensive 14 day Self Care Training Programme that is conducted at Lalgadh Leprosy Services Centre in Nepal. An evaluation of the programme was undertaken in which hospital admission for infected plantar ulceration was the outcome measure. This paper presents an overview of the issues related to impairment, a description of the Self Care Training Programme, an analysis of the evaluation results and a discussion of the findings"
Leprosy Review, Vol 72, Issue 3

Monitoring motor nerve function in leprosy patients

BRANDSMA, JW
September 2000

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"Manual muscle strength testing has an important function in the management of leprosy patients. Its importance was first recognized in the 1960s, especially when following patients who were started on steroid treatment to monitor the nerve function and the effect of treatment. In those days, and still in many centres today, many or all muscles were tested that are innervated by the nerves that can be at risk in leprosy. The author argues that not all muscles innervated by the nerves at risk need to be tested and also that many muscles cannot be tested in isolation. A muscle charting form is presented which is suitable for screening purposes, and that also allows for more detail when motor function is impaired"
Leprosy Review, Vol 71, Issue 3

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